Iowa Attorney General calls for legalizing fentanyl test strips

DES MOINES -- Iowa Attorney General Tom Miller on Thursday called on the Iowa Legislature to pass laws making it easier for people to test drugs for fentanyl and obtain overdose-reversing medication.

In a news conference, Miller said state lawmakers should legalize fentanyl testing strips, which can be used to test whether fentanyl is present in a pill or other substance, and also to expand the availability of naloxone, a medication that reverses the effects of an opioid overdose and prevents death.

Naloxone, under the brand name Narcan, is available for free without a prescription at certain pharmacies in Iowa, but Miller said the state should authorize nonprofits and government agencies to distribute the medication as well.

Miller’s comments came on the heels of Republican Gov. Kim Reynolds announcing plans last week to ratchet up awareness messaging at the state level around the dangers of fentanyl and illicit drug use.

Fentanyl is involved in the vast majority of opioid deaths in Iowa, being present in 83 percent of opioid deaths last year. Overall, drug overdose deaths have increased 34 percent in the last two years, from 350 in 2019 to 470 in 2021.

Fentanyl, a synthetic opioid that is up to 100 times stronger than morphine, is often added to illicit pills and other drugs, primarily because it makes the drugs cheaper to produce.

Last week, Reynolds highlighted its presence in counterfeit pills that look like prescription drugs such as OxyContin and Percocet.

Currently, fentanyl test strips are considered drug paraphernalia in Iowa. Possessing paraphernalia is a simple misdemeanor, punishable by up to 30 days in jail or a fine of $855.

“This should not be a partisan issue,” Miller said. “This is a harm reduction issue. This is a public health issue.”

Miller, a Democrat, said he’d had discussions with legislators on the measures during the last legislative session, and he’s hoping he can get support from both parties on passing the two laws.

Several states, including Georgia and Wisconsin, have decriminalized fentanyl test strips in recent years, with buy-in from Democrats and Republicans in their state legislatures. The National Association of Attorneys General, which Miller leads as president, has bipartisan support for the measure, Miller said.

“Dealing with this terrible set of issues concerning prescription opioids and fentanyl, it hasn't been a part of this partisan issue in Iowa,” he said.

Story County Sheriff Paul Fitzgerald said at the Thursday press conference that fentanyl test strips can be used by drug users to make safer decisions and prevent overdoses.

“This will allow the user to be able to either test the batch they have and if fentanyl is present during that, they can at that time choose a different batch, they can use less of what they have, they can have the option to have others there when they use it or have Narcan available,” he said.

Under current law, distributing naloxone outside a pharmacy is prohibited, but Miller said the Legislature should pass a bill to allow community organizations and nonprofits to apply to the state and receive naloxone that can be distributed to the public.

Under the proposed rules, the groups would not collect identifying information for the state’s prescription monitoring program.

Miller said the best option for people addicted to opioids is to seek treatment, but that these measures would lower the chances of fatal overdoses for those not in treatment.

“There's no better time to get into treatment,” he said. “And treatment is really the answer for people that are addicted.”